TOP TWELVE TIPSHEET for NEW PARENTS
The Most Common Questions in The First 100 Days
by Meredith Stedham RN, LPC
Educator, The Motherhood Center
At classes at The Motherhood Center, these are the topics that are most often raised by expecting and new parents. They ask: How much do babies sleep? How much do they eat? What exactly can you do to soothe them? These questions, plus the best baby gear, major milestones, tummy time, and doctor’s visits, are answered in this tip sheet.
On average, formula-fed babies will eat every 3 hours while breastfed babies will eat more frequently at every 2 1/2 hours. The difference in frequency is due to breastmilk being easier for babies to digest, and therefore their stomachs are ready for the next feeding sooner than formula-fed babies. Parents can anticipate an average of 8-12 feeding sessions per day for newborns. Infants will often also vary their feedings during times of growth spurts, and breastfed infants often will “cluster feed” in the evenings. It is generally recommended that breastfed babies be “fed on demand” while formula-fed babies may be placed on an every 3 hour feeding schedule.
According to the American Academy of Pediatrics, the average newborn spends at least 16 hours a day sleeping. However, there can be great variation from one baby to the next. It is essential for newborns to have successful, consistent, full feeding sessions in order to get their best sleep. New parents are advised to follow an eat, wake, sleep pattern for their newborns. The first 100 days of a new baby’s life will inevitably cause some sleep deprivation for new parents since newborns require around the clock feeding sessions. Parents should make a conscious effort to also take care of themselves – to nap and eat healthy meals so they are also well nourished and rested.
For the first few days after birth, the amount of wet diapers will vary depending on whether baby is formula-fed or breastfed, and also on the size and capacity of baby’s stomach. Then, once baby is able to fill their tummy to capacity and the milk supply has been well established for a breastfeeding mom, parents can expect babies will have an average of 8 to10 wet diapers per day. The amount and color of baby’s stool will change significantly from the first meconium stools to a more seedy, yellowish stool for breastfed babies and greenish stools for formula-fed babies. Parents can prevent diaper rash by keeping baby’s skin clean and dry. Diaper creams and ointments only need to be used if baby’s skin becomes irritated.
Infants, especially newborns, cry for many different reasons. Often they have a need such as being hungry, needing a diaper change, or just wanting to be held. There are many techniques that can help to soothe babies including singing, cuddling, or changing their environment if they are over-stimulated. The main recommendation I give parents when discussing soothing techniques is to follow the “5 S’s” developed by Dr. Harvey Karp to recreate the womb environment, which can help the baby feel more secure and calm. The “5 S’s” are: swaddling, side/stomach position, shushing sounds, swinging, and sucking. (Dr. Karp’s DVD, titled “The Happiest Baby on the Block,” is available at The Motherhood Center).
Newborns have several reflexes at birth such as the moro (startle) reflex, sucking reflex, and rooting reflex, which will fade over the course of several months. Parents will notice during the first 100 days that their baby is able to raise their head, follow moving objects with their eyes, focus on faces, begin to notice their own hands, and even learn to give their first social smiles. They may be able to hold and shake toys, even imitate some sounds and facial expressions.
It is recommended that healthy babies be provided with “tummy time” a few times a day lasting for a few minutes once they are discharged home. Tummy time can be time baby spends laying on their stomachs (with supervision) on a blanket or play mat, or it can be laying on mommy or daddy’s chest. Tummy time is important because it gives infants a chance to practice and master important motor skills that will prepare them for reaching future developmental milestones.
There are many practical and popular baby gear items available. In addition to the basic necessities of a diaper bag, a few outfits, and a safe crib & car seat, many parents also select an additional bassinet or portable crib to temporarily use in the master bedroom. Other potentially helpful items are a baby sling or carrier, baby stroller, bouncy seat, a nursing pillow (such as the My Breast Friend pillow), and a white noise machine. The item I recommend most to new parents to add to their shopping lists is the Miracle Blanket for swaddling baby.
Newborns should only be given a sponge bath until the umbilical cord has fallen off, and for baby boys until the circumcision has fully healed. After both areas have healed, then baby can be submerged in water for a tub bath. Pediatricians advise parents to keep the umbilical cord clean and dry. They may also advise you to clean around the umbilical cord with rubbing alcohol using a cotton swab every diaper change or a few times a day. Parents will be also be given instructions for circumcision care which usually involves applying petroleum jelly until the area heals in around 7-10 days.
The pediatrician will give you a schedule for well child visits during the first year. Most pediatricians will examine your baby either in the hospital or in their office around 2-4 days old, then again at 1-2 weeks old, 1 month old, and 2 months old. The doctor will monitor your baby’s length, weight, and head circumference on a growth chart, monitor baby for jaundice, and will discuss an immunization schedule. It is a good idea for parents to be prepared by writing a list of their questions prior to each appointment, in order to maximize their time with the doctor. Parents can also request a list of guidelines for the procedure and reasons (baby’s symptoms) that warrant contacting their healthcare provider.
For babies from birth to age 3 months, the American Academy of Pediatrics advises obtaining a rectal temperature with a digital thermometer as the most accurate method for measuring temperature. It is not recommended to do excessive consecutive rectal readings because the repeated insertion of the thermometer to the rectum can potentially cause inflammation or other complications. While there are other options available such as the tympanic (ear) thermometers and temporal artery thermometers that scan across the forehead, these devices are not as accurate as a rectal reading for infants under 3 months. The general guideline for parents is to call the doctor for a fever of 100.4 degrees or higher.
In 1992, the American Academy of Pediatrics released its recommendation that infants be placed for sleep in a “non-prone position.” Subsequently, in 1994, the “Back to Sleep” Campaign was launched. Since that time, the incidence of Sudden Infant Death Syndrome (SIDS) has decreased over 50 percent. Here are a few of the AAP guidelines to help reduce the risk of SIDS in infants up to 1 year of age: Always place baby on his back to sleep, use a firm sleep surface, keep loose bedding and other soft objects such as stuffed animals and toys out of the crib, and schedule & go to all well-child visits.
The transition to parenthood is a joyful time, but also a time filled with a tremendous amount of change. For new moms, the early postpartum period includes the physical recovery from delivery, sleep deprivation, and the emotional rollercoaster know as the “baby blues” while maternal hormones try to stabilize after giving birth. While the “baby blues” usually resolve within 2 weeks, for some women the symptoms can become more severe or more chronic leading to postpartum depression. It is important for new parents to seek support. The Motherhood Center hosts some support groups, as do many local hospitals, churches and community centers. Many neighborhoods also have moms and family groups that can be helpful.
The information contained here is only a brief introduction and overview of the first 100 days of an infant’s life and development. There are classes offered at The Motherhood Center for expecting and new parents, grandparents, and caregivers. The Motherhood Center also provides doula, baby nurse and babysitting services. It is located at 3701 W. Alabama. For more information call 713-963-8880 or visit www.motherhoodcenter.com